The Role and Impact of Animals With Pediatric Patients

Anna Tielsch Goddard, MSN, BS, RN, CPNP-PC; Mary Jo Gilmer, PhD, MBA, RN-BC, FAAN

Disclosures

Pediatr Nurs. 2015;41(2):65-71. 

In This Article

Canine Therapy With Children

In experimental studies within the pediatric population, physiological, psychological, and emotional benefits have been supported. For example, a pilot study on canine visitations with children in pain showed overarching themes that were often based on reducing anxiety (Sobo et al., 2006). These themes included providing distraction from the pain and/or situation, bringing pleasure and happiness, entertainment, reminding the child of home, enjoyment of snuggling and contact with the dog, providing company, calming, and pain easement (see Figure 2) (Sobo et al., 2006).

Figure 2.

Animal-Assisted Activities with Handler at National Pediatric Hospital
Source: Photograph courtesy of Children's Medical Center of Dallas, Texas. Used with permission. The author allows reprint permission and copyright release.

In a quasi-experimental study in 3- to 17-year-old hospitalized children who had AAT with a dog, a significant decrease in pain reports was found among subjects (Braun, Stangler, Narveson, & Pettingell, 2009). Group selection to the AAT intervention group (N = 18) was determined by eligibility requirements (including ability to use FACES pain scale, 3 to 17 years age range, not fearful or allergic to dogs, not in isolation) along with the dog being present when child was hospitalized. Designation to the control group (N = 39) was mainly dictated by a child's fear or allergy to dogs. AAT sessions were 15 to 20 minutes each. The AAT intervention group reported significant decrease in pain level compared to the control group (p = 0.006).

An earlier study focusing on children hospitalized on a pediatric oncology unit found 89% of the children who received canine therapy had increased independence and appetite, as well as decreased fear and pain from treatment and procedures (Gagnon et al., 2004). A descriptive pilot study in hospitalized post-operative 5- to 18-year-olds showed a significant decrease in physical pain and emotional distress as measured on a 1 to 10 scale with happy and sad faces on a ruler strip (p = 0.01) (Sobo et al., 2006). The AAT intervention in this study involved a therapy dog spending time with the child postoperatively. Activities included watching television with the child, being petted by the child, and doing tricks on command for the child. Researchers referred to this AAT intervention as "canine visitation therapy." Limitations to the study include a small convenience sample size (N = 25). This research involved post-intervention interviews and the investigators also analyzed the qualitative data obtained. Emerging themes reported by researchers included 1) the animal providing a distraction, pleasure, or entertainment; 2) the animal reminding the child of home; 3) snuggling; 4) providing company; and 5) easing pain (Sobo et al., 2006).

Anecdotal evidence from child psychologists show that AAT is especially useful in helping children who have been abused or neglected with subsequent insecure attachments (Parish-Plass, 2008). Clinical examples show that using AAT with these children helps foster trust and increases communication in children who otherwise have a strong distrust adults (Parish-Plass, 2008). No experimental studies have been published to further explore these clinical exemplars in this population.

A case study of a 12-year-old boy with autism reported increased participation in the presence of a therapy dog (Silva, Correia, Lima, Magalhaes, & de Sousa, 2011). The autistic child was exposed to two treatment conditions: a 1:1 structured activity with a therapist and certified therapy dog, and a 1:1 structured activity with the same therapist without the dog. On videotaped review, researchers and the therapist noted improvement was found when the child was with the therapy dog. These positive behaviors included smiling, increased positive physical contact, and less frequent and shorter durations of negative behaviors, such as aggression or outbursts (Silva et al., 2011).

An additional benefit reported from one study was improved staff moods on an inpatient unit. A pediatric oncology study using AFT on an inpatient floor also collected self-administered questionnaires from hospital staff. These results not only showed a change in the mood for the patients, but found reported improvements in hospital morale and motivation of the registered nurses on the floor (Gagnon et al., 2004).

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